40 
152. 


UC-MRUF 


35D   413 


DEPT.  OF 


ECONOMICS 


r°  3 


REATMENT 


I  METHODS   EMPLOYED   BY 
ORGANIZED    CHARITY    IN 
I  THE     REHABILITATION 
OF 


BY 

PORTER  R.  LEE 

GENERAL  SECRETARY  OF 

BTHE  PHILADELPHIA  SOCIETY  FOR 

ORGANIZING  CHARITY 


PUBLISHED   BY 
CHARITY   ORGANIZATION   DEPARTMENT 
*  THE   RUSSELL  SAGE  FOUNDATION 
NEW  YORK 
IQIO 


L 


THE  TREATMENT  OF 
NEEDY  FAMILIES  BY 
ORGANIZED  CHARITY 


ORGANIZED  charity,  like  all 
forms  of  social  work,  should 
be  an  effort  to  help  people 
to  lead  normal  lives.  We 
can  best  understand  just  what  nor- 
mal life  means  by  analyzing  it  into  its 
elements.  Without  attempting  a  scien- 
tific analysis,  we  may  set  up  as  the  irre- 
ducible minimum  of  elements  in  normal 
life  these  five:  health,  education,  em- 
ployment, recreation,  and  spiritual  de- 
velopment. Even  so  simple  a  standard 
of  normal  life  is  not  reached  by  many 
families,  whatever  their  position  in  the 
social  scale;  and  the  absence  of  one  or 
more  of  these  elements  does  not  neces- 
sarily mean  dependence,  but  it  does 
mean  abnormal  life,  of  which  dependence 
is  one  form. 

If  charitable  work  is  an  effort  to  pro- 
duce these  normal  life  elements  in  the 


712272 


families  with  which  it  deals,  it  is  neces- 
sary to  know  the  process  by  which  this 
is  done.  Here  we  observe  at  the  outset 
that  they  cannot  be  evolved  out  of  the 
family  fiber  with  no  outside  aid.  In 
/sfher  wordsj  .heafth,  education,  em- 
i>roymert£  :  £e*aea.fion,  and  spiritual 
.  deMelopjneat  all  require  the  co-operation 
^ASft^Qfamjry.wJtfi'fpf.c^s  outside  its  own 
circle.  Health  means  the  laws  of  sani- 
tation and  living,  the  health  regulations 
of  the  community,  the  services  of  a 
physician.  Education  means  schools, 
libraries,  and  experience  in  the  world  of 
activity  and  beauty.  Employment 
means  the  world  of  industry  and  com- 
merce. Recreation  means  public  parks 
and  the  community's  facilities  for 
amusement.  Spiritual  development 
means  the  church,  family  life,  and  the 
whole  range  of  human  relationships. 
Moreover,  all  these  factors  act  and  react 
upon  each  other  so  that  a  single  agency, 
like  the  school,  becomes  a  factor  not 
only  in  education  but  in  health,  em- 
ployment and  spiritual  development. 

Normal  life,  in  the  sense  in  which  we 
have  used  it,  is  not  possible  except 
through  co-operation  with  these  social 
forces.  That  family  whose  co-opera- 
tion is  most  intelligent  and  complete 


represents  normal  life  at  its  best.  That 
family  whose  co-operation  is  least  in- 
telligent and  complete  represents  ab- 
normal life  at  its  worst;  and  this  con- 
dition usually  spells  dependence.  The 
family  co-operation,  therefore,  or  its 
grip  upon  these  social  forces,  is  the  con- 
trolling factor  in  its  degree  of  normality. 
The  center  of  this  co-operation  in  the 
normal  family  is  the  intelligence  and 
devotion  of  the  parents.  In  such  a 
family,  health  is  safeguarded  by  pre- 
caution against  disease  and  by  prompt, 
efficient  treatment  when  sickness  comes; 
children  go  regularly  to  school  and  their 
progress  is  watched  and  furthered  by 
interest  at  home;  the  family  support  is 
secured  by  the  industry  of  the  wage- 
earning  members;  and  recreation  and 
spiritual  development  are  fostered  by 
participation  in  the  pleasures,  church 
attendance,  and  activities  of  wholesome 
family  life.  All  this  becomes  possible 
because  of  the  more  or  less  unconscious 
co-operation  fostered  by  the  family 
heads. 

Unless  we  are  to  forsake  our  original 
purpose  to  regard  charitable  work  as  an 
effort  to  help  people  lead  normal  lives, 
it  is  evident  from  this  brief  study  that 
we  must  regard  dependence  as  very 


much  more  than  a  condition  of  hunger 
and  cold  to  be  cured  by  food  and 
warmth.  Behind  the  hunger  and  cold 
is  the  absence  from  the  family  experience 
of  one  or  more  or  perhaps  all  of  the  ele- 
ments in  normal  life.  Those  who  are 
dealing  constantly  with  needy  families 
know  that  hunger  and  cold  are  only  the 
surface  indication  of  deeper  trouble. 
Parental  ignorance,  unwholesome  sur- 
roundings, exposure  to  contagion,  are  a 
constant  danger  to  health.  Children  do 
not  go  regularly  to  school,  or  if  they  do 
go,  they  do  not  learn  because  they  are 
suffering  from  needless  physical  defects. 
Uncertain  employment  means  uncer- 
tain living  with  its  menace  to  both 
health  and  character.  Stolidity,  de- 
pravity, ignorance,  and  impassivity  are 
barriers  to  even  those  limited  spiritual 
influences  which  a  narrow  life  may 
afford. 

The  fatal  defect  of  "small  change" 
charity  which  is  content  with  a  gift  of 
money  or  food  is  that  it  ministers  in- 
adequately to  one  aspect  of  need  only, 
and  wholly  disregards  every  other  as- 
pect. It  feeds  the  poor  spasmodically; 
but  it  does  not  help  them  in  any  real 
sense.  No  treatment  which  does  not 
reach  all  the  factors  in  a  family's  de- 
6 


pendence  can  be  called  either  intelligent 
or  humane.  In  other  words,  all  the 
various  elements  in  normal  life  must  be 
produced  in  the  life  of  the  needy  family 
before  it  can  be  lifted  out  of  dependence. 

THOROUGH  TREATMENT 
ILLUSTRATED 

AS  an  illustration,  showing  the 
contrast  between  charitable 
treatment  which  considers  one 
phase  of  dependence  only,  and 
that  which  considers  all  phases,  let  us 
consider  the  case  of  a  widow  with  five 
children,  an  average  example  of  a  very 
common  type  of  charitable  problem. 
Her  husband,  a  day  laborer,  earning 
the  minimum  wage,  had  died  leaving  no 
savings  and  no  insurance,  and  her  appli- 
cation for  relief  followed  a  few  days  later. 
The  first  plan  of  treatment  tried  was 
that  of  a  weekly  dole  to  supplement 
whatever  resource  there  might  be  with- 
in the  family  itself.  The  only  possible 
wage-earner  was  the  woman,  the  chil- 
dren, with  one  exception,  an  infant, 
being  of  school  age.  Later,  the  woman's 
sister,  a  girl  of  sixteen,  entered  the 
household  and  contributed  to  the  family 
support.  While  both  were  away  at 


work,  the  children  were  cared  for  by  the 
woman's  mother  who  agreed  to  render 
this  service,  but  could  not  take  the 
whole  family  to  live  with  her. 

This  was  treatment  reaching  one  sole 
element  in  the  family  life — hunger  and 
cold  relieved  by  the  family  earnings, 
supplemented  by  a  weekly  dole.  After 
a  year,  instead  of  being  restored  to 
normal  life  which  should  have  been  the 
goal  of  any  sound  plan  of  treatment,  the 
family  was  more  dependent  than  ever, 
because  two  other  elements,  the  wom- 
an's health  and  the  moral  welfare  of  the 
children,  had  been  wholly  disregarded. 
Both  suffered  from  the  neglect  of  this 
ineffective  charity. 

The  problem  was  then  attacked  on  a 
far  reaching  plan,  looking  toward  ulti- 
mate independence,  although  this  must 
be  years  in  the  future.  The  weak  points 
in  the  family  fiber  seemed  to  be  the 
woman's  health,  the  lack  of  income,  the 
poor  school  record  of  the  children  and 
their  growing  waywardness.  It  was 
obvious  that  complete  independence 
could  never  be  worked  out  until  all 
these  conditions  had  been  considered 
and  met,  which  meant  restored  health 
for  the  woman,  regular  school  attend- 
ance and  wholesome  influence  for  the 
8 


boys,  and  regular  support  from  char- 
itable sources,  supplementing  the  lim- 
ited family  income,  until  there  were 
wage-earners  enough  in  the  family,  as 
the  children  became  older,  to  make  this 
unnecessary. 

Only  the  first  two  features  of  this  plan 
have  been  carried  out.  The  woman's 
health  has  been  restored  and  she  is  now 
the  efficient  head  of  her  own  household, 
giving  to  the  children  regular  school 
attendance,  and  careful  watching,  in 
which  she  is  assisted  by  an  interested 
friend.  It  will  be  two  years  before 
there  will  be  income  enough  in  the  fam- 
ily to  justify  the  withdrawal  of  financial 
charitable  support,  but  there  is  every 
evidence  that  the  plan  is  working  out 
successfully  after  nearly  two  years' 
trial. 

In  this  family,  fairly  low  in  the  scale 
of  abnormal  life  when  first  it  applied  for 
help,  all  but  one  of  the  elements  of  nor- 
mal life  have  been  produced,  either  en- 
tirely or  in  part,  and  this  one,  employ- 
ment, will  appear  when  the  children 
become  old  enough  to  work.  In  order 
to  produce  this  result,  it  has  been  neces- 
sary to  effect  the  co-operation  of  the 
family  with  the  following  agencies  and 
social  forces:  a  physician,  a  visiting 


nurse,  a  diet  kitchen,  a  dispensary,  a 
tuberculosis  sanitarium,  a  public  school 
and  two  of  its  teachers,  two  temporary 
foster  homes,  a  friendly  visitor,  a  relief 
society,  a  day  nursery,  a  church,  and 
the  woman's  own  kindred. 

If  we  regard  this  illustration  from  the 
point  of  view  with  which  we  began  this 
paper,  it  becomes  evident  that  the  de- 
pendence of  this  family  was  due  to  the 
failure  of  its  members,  for  some  reason, 
to  co-operate  with  those  social  forces 
which  make  normal  life  possible.  This 
brings  us  to  the  fundamental  and  signifi- 
cant task  of  organized  charity  which  is 
to  organize  artificially  this  co-operation 
for  the  family  and  continue  it  until  the 
family  is  once  more  able  on  its  own  ac- 
count to  grip  the  elements  of  normal 
life. 

THE    DEEPER   MEANING   OF 
ORGANIZED   CHARITY 

IN  the  remainder  of  this  paper  we 
shall  devote  ourselves  to  a  discus- 
sion of  the  meaning  of  organized 
charity,  and  the  methods  which  it 
uses  with  dependent  families,  an  example 
of  which  we  have  just  considered.  Organ- 
ized charity  is  commonly  associated  with 
10 


a  society  with  a  name  which  is  a  com- 
plete misconception.  Chanty  is  neither 
a  society  nor  an  institution.  It  is  the 
help  which  individuals  bestow  upon  the 
needy.  Societies  are  only  devices  which 
men  have  created  in  order  to  help  them 
to  be  charitable  more  effectively.  They 
are  merely  channels  through  which  the 
charity  of  a  community  may  flow  from 
its  people  to  its  poverty,  with  least 
waste  and  with  greatest  efficiency.  Ap- 
plied to  dependent  families,  charity 
ought  to  mean  all  the  various  forms  of 
help,  outside  the  family  circle,  which 
are  necessary  to  restore  the  family  to 
normal  life.  What  these  forms  of  help 
are — school,  medical  care,  relief,  whole- 
some influences,  etc. — we  have  already 
considered;  when  they  are  working  har- 
moniously and  effectively  to  bring  about 
the  family  independence,  we  have  or- 
ganized charity.  The  term  means  noth- 
ing else,  and  we  have  no  right  to  use  it 
except  as  applied  to  the  orderly,  co- 
operative efforts  of  all  the  social  forces 
necessary  to  the  wisest  and  most  effect- 
ive care  of  the  poor. 

Organization  implies  some  organizing 
force,  a  responsible  center  for  the  co- 
ordination of  effort;  implies,  in  other 
words,  as  applied  to  charity,  a  center 
ii 


of  the  dependent  family's  co-operation 
with  those  resources  within  and  outside 
its  own  circle  which  are  essential  to 
independence.  Any  agency  which  is 
fostering  this  co-operation  for  a  family 
that  has  lost  its  grip  upon  the  elements 
of  normal  life  is  such  a  center  of  organi- 
zation, and  is  working  upon  the  princi- 
ples of  organized  charity,  whatever 
name  it  bears.  Organized  charity  is 
no  more  than  this,  but  let  us  realize 
this  in  sober  earnest — it  is  no  less. 

The  methods  of  organized  charity 
have  become  firmly  established.  If 
we  can  avoid  the  charge  of  being  trite, 
it  may  be  worth  while  to  consider  them 
from  the  point  of  view  of  co-operation. 

The  first  function  of  charity  is  to  re- 
lieve suffering,  and  the  second  is  to  pre- 
vent it.  Hence  the  first  task  of  the 
charity  organizationist  is  to  provide 
food  and  fuel  to  families  which  are  suf- 
fering from  hunger  and  cold.  When  this 
is  done,  he  is  free  to  take  up  his  larger 
task  of  preventing  future  suffering. 

The  first  step  in  this  larger  task  is  to 
secure  an  adequate  knowledge  of  facts. 
Reverting  again  to  our  conception  of 
normal  life,  we  will  recall  the  five  ele- 
ments which  are  essential  to  it,  and 
which,  in  the  case  of  dependent  families, 

12 


organized  charity  must  develop  through 
the  co-operation  of  social  forces  with  the 
family  resources.  It  is  obvious  that  we 
cannot  understand  how  far  these  ele- 
ments are  missing  and  how  far  charity 
must  go  in  supplementing  them  without 
a  careful  inquiry  into  the  situation. 
This  process  we  call  investigation.  The 
diagnosis  of  the  charity  organizationist 
which  he  calls  an  investigation  is  as  nec- 
essary in  purpose  and  as  kind  in  method 
as  the  physician's  investigation  which  he 
calls  diagnosis;  and  the  two  are  closely 
akin.  In  treating  each  one  of  a  thou- 
sand patients  a  physician  needs  to  know 
just  what  physical  defects  his  patient 
suffers  from,  what  caused  them,  how 
they  are  related,  what  there  is  in  his 
habits  of  life  or  family  history  which  will 
explain  them,  what  resources  of  vitality 
and  constitutional  strength  he  has  to 
help  him,  and  whether  their  cure  calls 
for  special  diet,  exercise,  a  surgical  oper- 
ation, hospital  care,  change  of  environ- 
ment or  the  use  of  drugs.  Similarly  in 
trying  to  restore  a  thousand  needy 
families  to  normal  life,  we  need  to  know 
in  each  case  what  elements  are  missing, 
what  are  the  more  obvious  and  what  are 
the  more  deep-seated  needs,  what  caused 
them,  how  they  are  related,  what  there 

13 


is  in  the  family  history  and  habits  of 
life  that  will  explain  them,  what  re- 
sources, physical,  spiritual,  financial, 
the  family  have  to  help  them  in  their 
rehabilitation,  and  whether  this  calls  for 
medical  care,  education,  employment, 
more  wholesome  environment,  liberal 
relief  or  a  combination  of  many  of 
these. 

THE  NECESSARY   BASIS   FOR 
TREATMENT 

AN  investigation,  properly  made, 
will  conserve  the  family  self- 
respect  and  leave  an  impression 
of  confidence  in  the  sympathy 
and  resourcefulness  of  the  investigator. 
The  knowledge  of  facts  which  it  reveals 
is  essential  not  only  as  showing  the 
family's  own  resources  but -also  as  show- 
ing the  weak  points  in  the  family 
fiber  toward  which  charity  can  direct 
its  efforts.  The  necessary  co-operation 
of  charitable  forces  can  be  organized  on 
no  other  basis.  To  know  what  to  do  and 
when  and  where  to  do  it,  requires  some- 
thing more  than  the  impressions  and 
preconceived  judgments  of  the  doer. 
It  requires  as  clear  a  grasp  of  the  situa- 
tion and  the  way  out  as  a  physician  has 


of  his  patient's  condition  before  he 
begins  his  treatment. 

The  facts  once  gathered,  a  sound  plan 
of  treatment,  looking  toward  the  ulti- 
mate restoration  of  the  family  to  nor- 
mal life,  should  follow  naturally.  It 
will  have  three  chief  features.  It 
will  consider  all  the  factors  in  the  family 
dependence  and  will  organize  the  treat- 
ment with  reference  to  them  all.  It 
will  provide  for  treatment  adequate 
enough  to  put  the  family  forever  be- 
yond dependence  once  it  is  withdrawn, 
if  this  is  possible.  It  will  make  very 
clear  just  what  social  forces  are  neces- 
sary to  co-operate  in  this  result  and  at 
just  what  points  their  co-operation  is 
needed.  A  dependent  family  whose 
needs  are  studied  and  treated  according 
to  these  thorough-going  principles,  can 
usually  be  restored  to  normal  life  by  or- 
ganized charity. 

It  is  important  to  recognize  that  in 
many  cases  these  principles  cannot  be 
applied,  and  failure  is  the  result.  Leav- 
ing out  the  personal  equation,  this  is  due 
usually  to  bad  social  conditions  affecting 
the  life  or  character  of  the  family  with 
which  the  case-work  method  cannot 
cope.  Intemperance,  preventable  dis- 
ease, and  defective  school  facilities  are 

15 


illustrations.      These     are     condi  ens 
which  must  be  removed  by  legish      n 
and  a  higher  standard  of  social  etl 
both  developed  with  the  aid  of  pul 
opinion.    The  experience  of  those  who 
deal  with  dependent  families,  if  rightly 
studied  and  interpreted,  will  furnish'  a 
basis  of  fact  for  :these  social   ref  rra 
campaigns  unrivalled  for  bald,  convinc- 
ing truth.   Considered  from  the  poin*  o-' 
view  of  charity  organized  to  help  pec 
lead  normal  lives,  this  is  as  imperativ „ 
duty  as  the  relief  of  the  widow  and  b 
children. 

Health,  education,  employment,  r?t- 
reation,  spiritual  development — org~ 
ized  charity  means  the  co-operatioi 
social  forces  in  an  effort  to  bring  *  e^e 
elements  into  the  lives  of  the  depend  ;f?,f 
poor,  and  to  encourage  the  eradica    jn 
of  those  social  evils  which  are  di.;1v 
forcing  other  families  to  lose  their  gn'p 
upon  normal  life. 


14  DAY   USE 

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LOAN  DEPT. 

•  on  the  last  date  stamped  belcy 

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General  Libran 


